Many states have benefit programs (e.g., special fund, second injury fund, subsequent injuries fund, special disabilities trust fund) for people with significant pre-existing impairment and/or disability who are injured. Each fund has different rules and regulations. Some of these funds provide benefits to the injured worker, while others reimburse eligible employers and insurers. Physicians need to understand the specific requirements of benefit programs in their states. Evaluating physicians who understand the uniqueness of these programs will be better able to provide valuable services. This article provides insights into one such program, the subsequent injuries benefits trust fund (SIBTF) in California. To be eligible for SIBTF benefits, the injured worker must meet an “overall threshold” and an “industrial threshold” of disability to qualify for benefits. If these thresholds are met, the injured worker may receive additional compensation based on pre-existing (labor-disabling) disability. The pre-existing disabilities can arise from any source, including congenital, developmental, or acquired disease, prior injury, war injury, non- industrial injuries, or prior industrial disabilities.